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This is VAERS ID 1395591

History of Changes from the VAERS Wayback Machine

First Appeared on 6/18/2021

VAERS ID: 1395591
VAERS Form:2
Age:64.0
Sex:Male
Location:Virginia
Vaccinated:2021-03-11
Onset:2021-06-03
Submitted:0000-00-00
Entered:2021-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN N/A / N/A AR / IM

Administered by: Private      Purchased by: ??
Symptoms: Dehydration, Dyspnoea, Glomerular filtration rate normal, Hyperhidrosis, Supraventricular tachycardia, Laboratory test, Acute kidney injury

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prescriptions: Atorvastatin [Lipitor], Celecoxib [Celebrex], Cyclobenzaprine [Flexeril], Duloxetine HCl [Cymbalta], & Gabapentin [Neurontin]; Over-the Counter: Cetirizine HCl [Zyrtec], Diphenhydramine HCl [Benadryl], Fish Oil, Fluticasone
Current Illness: None
Preexisting Conditions: High cholesterol, high blood pressure, bone spurs & arthritis in cervical spine, multilevel degenerative disk disease in lumbar spine.
Allergies: Occasional mild itching when taking opioids.
Diagnostic Lab Data: All tests on 6/3/2021. Hemolysis Index 34, EGFR 50.8.
CDC 'Split Type':

Write-up: Heart rate 186, shortness of breath, profuse sweating. Successfully treated with IV adenosine [ADENOCARD]. Diagnosed as SVT (supra ventricular tachycardia), AKI (acute kidney injury), and dehydration.

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